VA Appeals: Your Options After a Denial or Low Rating

A Denial Isn't the End

Here's the number that should change how you think about VA claims: roughly 1 in 5 denied claims gets overturned on appeal. At the Board of Veterans' Appeals, grant rates have hovered around 35-40% in recent years. That's not a coin flip — but it's a lot better than zero.

And yet most veterans never appeal.

Some don't know they can. Some read the decision letter and assume the VA has the final word. Some get frustrated with a system that already made them wait months for an answer. That frustration is legitimate — but walking away from a denial you disagree with is almost always the wrong move. The VA's own data shows that veterans who pursue appeals win at rates that would surprise most people.

The reasons behind denials vary — insufficient medical evidence, missing service connection, a C&P exam that didn't capture your condition accurately. But regardless of why you were denied, the process for challenging that decision is the same. You pick a lane. You file the right form. And you give the VA a reason to look again.

Understanding Your Decision Letter

Your decision letter is more than a yes or no. It's a roadmap — if you know how to read it.

The most important section is called "Reasons and Bases." This is where the VA explains exactly why they made the decision they made. It'll cite specific evidence they reviewed, what the C&P examiner said, and which legal standard you didn't meet. Under 38 CFR § 3.103(b), the VA is required to provide this explanation. Don't skim it. Read every word.

Here's what to look for:

• What evidence was missing? The letter will often say something like "there is no medical evidence showing a current diagnosis" or "the evidence does not establish a nexus to service." That tells you exactly what to fix.
• Which element of service connection failed? You need three things: a current diagnosis, an in-service event or injury, and a medical nexus linking them. The decision letter will tell you which leg of the stool collapsed.
• What did the C&P examiner conclude? If the examiner provided a negative opinion — "less likely than not related to service" — that's almost certainly what sank your claim. Knowing this tells you whether you need a new medical opinion or whether the examiner simply got it wrong.
• Were there procedural errors? Did the VA fail to obtain records you told them about? Did they schedule a C&P exam for the wrong condition? These are duty-to-assist errors, and they matter for your appeal lane choice.

The Three Appeal Lanes

Before February 2019, the VA appeals system was a nightmare. One track, massive backlogs, average wait times measured in years. The Appeals Modernization Act (AMA) — Public Law 115-55 — replaced that with three distinct lanes, each designed for different situations. Think of them as parallel paths, not sequential steps.

The three lanes are:

• Supplemental Claim (VA Form 20-0995) — Submit new evidence and get a fresh review
• Higher-Level Review (VA Form 20-0996) — Ask a senior reviewer to re-examine the existing evidence
• Board of Veterans' Appeals (VA Form 10182) — Take your case to a Veterans Law Judge

You don't have to go through them in order. You can jump straight to the Board if you want. You can file a Supplemental Claim, lose, then go to Higher-Level Review. The lanes aren't a hierarchy — they're options. And picking the right one is probably the single most important decision you'll make in your appeal.

Lane 1: Supplemental Claim

The Supplemental Claim is the most common appeal path — and for good reason. It's the only lane that lets you add new evidence to the record. Filed on VA Form 20-0995, it tells the VA: "Here's something you didn't see before. Look again."

When to Use It

Use a Supplemental Claim when your denial was an evidence problem, not a procedural problem. If the VA said "no nexus between your condition and service," and you can get an independent medical opinion (IMO) establishing that nexus — that's textbook Supplemental Claim territory.

Common new evidence includes:

• A private medical nexus letter or independent medical opinion
• Buddy statements from fellow service members
• Updated medical records showing worsening conditions
• Service records that weren't previously in the file
• A new diagnosis that reframes the condition

What "New and Relevant" Actually Means

Under 38 CFR § 3.156(a), the evidence must be new (not previously submitted) and relevant (it has to address the reason for the denial). A new buddy statement saying "he was a good soldier" isn't relevant if the denial was about a missing medical diagnosis. But a new statement saying "I witnessed his injury in Afghanistan in 2009" is relevant if the VA denied the in-service event.

The bar here is intentionally low. The VA isn't asking for a smoking gun — they're asking for something new that addresses the gap. And here's what most veterans don't realize: the VA has a duty to assist you in obtaining evidence for Supplemental Claims. If you identify records that might help — VA medical records, military personnel records, Social Security records — the VA is obligated to go get them.

Lane 2: Higher-Level Review

Higher-Level Review is the most underused lane in the system. And that's a problem, because it's often the fastest route to a win.

Filed on VA Form 20-0996, a Higher-Level Review sends your claim to a more experienced rater — a Decision Review Officer (DRO) — who examines the same evidence that was already in the record. You can't submit new evidence. That sounds limiting, but it's actually the point. You're not saying "here's new stuff." You're saying "you got it wrong the first time."

When to Use It

• Clear and unmistakable error (CUE) — The rater misread the evidence, applied the wrong regulation, or ignored favorable evidence in the record
• Duty-to-assist errors — The VA failed to get records you identified, didn't provide a required exam, or scheduled an exam with the wrong specialist
• Benefit of the doubt wasn't applied — Under 38 CFR § 3.102, when evidence is roughly equal for and against, the VA must rule in your favor. This gets ignored more than it should.

The Informal Conference

When you file a Higher-Level Review, you can request an informal conference — a phone call with the DRO (or your representative can take the call). This is huge. It's your chance to verbally walk the reviewer through the error you think was made. You can't submit new evidence on the call, but you can point to specific items in the existing record and explain why they should have been weighed differently.

Always request the informal conference. Always.

Higher-Level Reviews average about 125 days — roughly the same as Supplemental Claims. But because no new evidence development is needed, they can sometimes be faster. And if the DRO agrees the original decision was wrong, the turnaround can be remarkably quick.

Lane 3: Board of Veterans' Appeals

The Board is the big one. Filed on VA Form 10182 (Notice of Disagreement), it puts your case in front of a Veterans Law Judge (VLJ). The Board is independent from the regional offices that denied you in the first place — and that independence matters. Board judges grant claims at higher rates than regional office reviewers.

But there's a trade-off: time. Board appeals take longer. Sometimes significantly longer. You need to decide whether a higher chance of winning is worth the wait.

Three Dockets Within the Board

When you file at the Board, you choose one of three dockets:

• Direct Review — The judge reviews the existing record. No new evidence, no hearing. Fastest Board option, averaging around 365 days.
• Evidence Submission — You get 90 days after filing to submit additional evidence. The judge reviews everything. Takes a bit longer — often 12-18 months.
• Hearing Request — You get a live hearing with the judge (virtual or in-person), plus 90 days after the hearing to submit more evidence. This is the most thorough option but also the slowest — expect 1-2 years, sometimes more.

The hearing option is worth highlighting. A hearing lets you tell your story directly to the person deciding your case. For conditions with complex histories — PTSD with multiple stressors, progressive diseases, conditions where the records don't tell the whole story — a hearing can be the difference between a grant and a denial.

Choosing the Right Lane

This is where most veterans get it wrong. They pick a lane based on vibes instead of strategy. Don't do that. Your decision letter tells you which lane to use — if you read it carefully.

The Decision Tree

Do you have new evidence that addresses the reason for the denial?

→ Yes → Supplemental Claim (Form 20-0995)

Was there an error in how the existing evidence was evaluated — a regulation misapplied, evidence ignored, benefit of the doubt not given?

→ Yes → Higher-Level Review (Form 20-0996)

Did the VA fail in its duty to assist — missing records, no exam, wrong exam?

→ Yes → Higher-Level Review (Form 20-0996) — the DRO can identify and correct the error

Is your case complex, with conflicting medical opinions, and you want the strongest possible review?

→ Yes → Board of Veterans' Appeals (Form 10182) with a hearing

Have you already lost at Higher-Level Review and still believe the decision was wrong?

→ Board appeal or Supplemental Claim with new evidence

Timelines and Deadlines

Deadlines in the VA system aren't suggestions. Miss one and it can cost you years of back pay.

The 1-Year Window

From the date on your decision letter, you have exactly one year to file in any of the three lanes. File within that year and your appeal is considered a "continuously pursued claim" — meaning if you win, your effective date goes back to the original filing. This is the single most valuable protection in the system. Don't blow it.

What Happens If You Miss the Window

If you miss the 1-year mark, the decision becomes final. You can still file a Supplemental Claim at any time — there's no outer time limit on those. But your effective date resets to the date of the new Supplemental Claim. You lose all the back pay that would have accrued from the original filing date.

For some veterans, that's tens of thousands of dollars. For others with years-long claim histories, it can be six figures. Don't let a deadline turn a win into a partial win.

Average Processing Times

• Supplemental Claim: ~125 days (4 months)
• Higher-Level Review: ~125 days (4 months)
• Board — Direct Review: ~365 days (1 year)
• Board — Evidence Submission: ~12-18 months
• Board — Hearing Request: ~1-2 years
• CAVC (after Board denial): ~1-2 additional years

These are averages. Your mileage will vary based on the complexity of the case, the regional office workload, and whether additional development is needed. But they give you a realistic frame for planning.

Effective Dates on Appeal

Effective dates determine when your benefits start — and that determines how much back pay you receive. This is where real money is at stake.

Under 38 CFR § 3.400, the general rule is: your effective date is the date the VA received your original claim, or the date entitlement arose, whichever is later. But this only holds if you've continuously pursued the claim through the appeals process.

How Backdating Works

Say you filed a claim on January 15, 2024. The VA denied it on June 1, 2024. You file a Supplemental Claim on November 1, 2024 — well within the 1-year window. You win the Supplemental Claim on March 15, 2025. Your effective date goes back to January 15, 2024 — the original filing date. That's 14 months of back pay.

Now imagine you waited until July 2025 — past the 1-year window — and filed a new Supplemental Claim. Even if you win, your effective date is July 2025. Same condition, same rating, but 18 fewer months of back pay.

Protecting Your Effective Date

• File within the 1-year window. Non-negotiable.
• If you switch lanes, do it cleanly. Withdraw from one lane and file in another before the year expires.
• Keep records of every filing. Dates matter. If there's ever a dispute about when you filed, your documentation is your proof.
• Use Intent to File (VA Form 21-0966) strategically — it establishes a date up to one year before you submit the full claim, which can protect your effective date even further back.

Common Appeal Mistakes

I've seen the same mistakes destroy strong appeals over and over. Here are the ones that cost veterans the most:

1. Picking the Wrong Lane

Filing a Higher-Level Review when you need new evidence. Filing a Supplemental Claim when the real issue is a rater error. The lane choice should flow directly from your decision letter — what went wrong determines what comes next. Don't guess. Analyze.

2. Missing the 1-Year Deadline

The number one effective-date killer. A veteran files a claim, gets denied, spends 14 months "thinking about it," then files a Supplemental Claim. They win — but their effective date is 14 months later than it should have been. At a 70% rating, that's roughly $22,000 in lost back pay. Set a calendar reminder the day you receive a denial.

3. Filing a Supplemental Claim Without New Evidence

If you file a Supplemental Claim and the VA determines your evidence isn't "new and relevant," they'll send you a duty-to-notify letter and give you time to respond. But many veterans just re-submit the same records and expect a different result. That's not how this works. You need something the VA hasn't seen — and it needs to address the specific gap that caused the denial.

4. Weak or Generic Nexus Letters

A nexus letter that says "it is at least as likely as not that this condition is related to military service" without explaining why is barely better than no letter at all. Good nexus letters cite your specific service records, explain the medical mechanism, and address any contrary evidence in the file. They tell a medical story, not just a legal conclusion.

5. Going It Alone When You Don't Have To

Free VSO representation exists for a reason. Accredited claims agents and attorneys work on contingency for a reason. The appeals process rewards preparation and knowledge of VA regulations. If you wouldn't represent yourself in court, don't represent yourself at the Board. At minimum, get a VSO involved — DAV, VFW, American Legion, and Disabled American Veterans all provide free help.

Frequently Asked Questions